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Active, not recruitingNCT04770753Updated Sep 28, 2026Results posted

A Study Evaluating the Efficacy and Safety of Mitapivat in Participants With Non-Transfusion-Dependent Alpha- or Beta-Thalassemia (α- or β-NTDT)

A Phase 3 interventional study of Placebo Matching Mitapivat and Mitapivat in Non-Transfusion-dependent Alpha-Thalassemia and Non-Transfusion-dependent Beta-Thalassemia, sponsored by Agios Pharmaceuticals, Inc.. Active, not recruiting at 68 sites in 18 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-28.

Sponsored by Agios Pharmaceuticals, Inc. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
194
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The primary purpose of this study was to compare the effect of mitapivat versus placebo on hemolytic anemia in participants with alpha- or beta-non-transfusion dependent thalassemia (NTDT).

Read the detailed description

The mitapivat group included 130 participants whereas the placebo group had 64 participants.

02

Conditions studied

  • Non-Transfusion-dependent Alpha-Thalassemia
  • Non-Transfusion-dependent Beta-Thalassemia
03

In context

Lead sponsor

Agios Pharmaceuticals, Inc. is the lead sponsor of 52 studies on the registry; 6 are open to participants now.

Of its 23 completed or terminated interventional studies of FDA-regulated products, 4 (17%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Documented diagnosis of thalassemia (β-thalassemia with or without α-globin gene mutations, hemoglobin E (HbE)/β-thalassemia, or α-thalassemia/hemoglobin H [HbH] disease) based on Hb electrophoresis, Hb high-performance liquid chromatography (HPLC)), and/or deoxyribonucleic acid (DNA) analysis;
  • Hb concentration ≤10.0 grams per deciliter (g/dL) (100.0 grams per liter [g/L]), based on an average of at least 2 Hb concentration measurements (separated by ≥7 days) collected during the Screening Period;
  • Non-transfusion-dependent, defined as ≤5 red blood cell (RBC) units during the 24-week period before randomization; and no RBC transfusions ≤8 weeks before providing informed consent and no RBC transfusions during the Screening Period;
  • If taking hydroxyurea, the hydroxyurea dose must be stable for ≥16 weeks before randomization;
  • Women of child-bearing potential (WOCBP) must be abstinent of sexual activities that may result in pregnancy as part of their usual lifestyle or agree to use 2 forms of contraception, one of which must be considered highly effective, from the time of providing informed consent, throughout the study, and for 28 days after the last dose of study drug. The second form of contraception can be an acceptable barrier method;
  • Written informed consent before any study-related procedures are conducted and willing to comply with all study procedures for the duration of the study.

Exclusion criteria

Exclusion Criteria:

  • Pregnant, breastfeeding, or parturient
  • Documented history of homozygous or heterozygous sickle hemoglobin (HbS) or hemoglobin C (HbC);
  • Prior exposure to gene therapy or prior bone marrow or stem cell transplantation;
  • Currently receiving treatment with luspatercept; the last dose must have been administered ≥18 weeks before randomization;
  • Currently receiving treatment with hematopoietic stimulating agents; the last dose must have been administered ≥18 weeks before randomization;
  • History of malignancy, (active or treated) ≤5 years before providing informed consent;
  • History of active and/or uncontrolled cardiac or pulmonary disease ≤6 months before providing informed consent, except for nonmelanomatous skin cancer in situ, cervical carcinoma in situ, or breast carcinoma in situ;
  • Hepatobiliary disorders;
  • Estimated glomerular filtration rate \<45 milliliters per minute (mL/min)/1.73 m\^2 by Chronic Kidney Disease Epidemiology Collaboration creatinine equation;
  • Nonfasting triglycerides >440 milligrams per deciliter (mg/dL) (5 millimoles per liter [mmol/L]);
  • Active infection requiring systemic antimicrobial therapy at the time of providing informed consent;
  • Positive test for hepatitis C virus antibody (HCVAb) with evidence of active HCV infection, or positive test for hepatitis B surface antigen (HBsAg);
  • Positive test for human immunodeficiency virus (HIV)-1 antibody (Ab) or HIV-2 Ab;
  • History of major surgery (including splenectomy) ≤16 weeks before providing informed consent and/or a major surgical procedure planned during the study;
  • Current enrollment or past participation (≤12 weeks before administration of the first dose of study drug or a timeframe equivalent to 5 half-lives of the investigational study drug, whichever is longer) in any other clinical study involving an investigational treatment or device;
  • Receiving strong CYP3A4/5 inhibitors that have not been stopped for ≥5 days or a timeframe equivalent to 5 half-lives (whichever is longer); or strong CYP3A4 inducers that have not been stopped for ≥4 weeks or a timeframe equivalent to 5 half-lives (whichever is longer), before randomization;
  • Receiving anabolic steroids that have not been stopped for at least 4 weeks before randomization. Testosterone replacement therapy to treat hypogonadism is allowed. The testosterone dose and preparation must be stable for ≥10 weeks before randomization;
  • Known allergy to mitapivat or its excipients (microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, and magnesium stearate, Opadry® II Blue [hypromellose, titanium dioxide, lactose monohydrate, triacetin, and FD\&C Blue #2]);
  • Any medical, hematological, psychological, or behavioral condition(s) or prior or current therapy that, in the opinion of the Investigator, may confer an unacceptable risk to participating in the study and/or could confound the interpretation of the study data Also excluded are:

    • Participants who are institutionalized by regulatory or court order
    • Participants with any condition(s) that could create undue influence (including but not limited to incarceration, involuntary psychiatric confinement, and financial or familial affiliation with the Investigator or Sponsor)
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
194 participants (actual)

Study arms

  • Experimental
    Mitapivat

    Mitapivat 100 milligrams (mg), orally, twice daily (BID) for 24 weeks in double blind (DB) period and for up to 5 years in open label extension (OLE) period.

    Drug: Mitapivat

  • Placebo comparator
    Placebo

    Placebo matching mitapivat, orally, BID for 24 weeks in double blind period followed by Mitapivat 100 mg, orally, BID for up to 5 years in open label extension period.

    Drug: Placebo Matching Mitapivat · Drug: Mitapivat

Interventions

  • DrugPlacebo Matching Mitapivat

    Tablets

  • DrugMitapivat

    Tablets

    Also known as: AG-348, AG-348 sulfate hydrate, Mitapivat sulfate

06

What researchers measure

Primary outcomes

  1. Double-Blind Period: Percentage of Participants Who Achieved Hemoglobin (Hb) Response From Week 12 Through Week 24 Compared With Baseline

    Hb response is defined as ≥10 grams/ liter (g/L) (1.0 gram per deciliter) (g/dL) increase in average Hb concentration from Week 12 through Week 24 compared with baseline. Hb response was tested using the Mantel-Haenszel stratum weighted method adjusting for randomization stratification factors. Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline up to Week 12 through Week 24

Secondary outcomes

  1. Double-Blind Period: Change From Baseline in Average Functional Assessment of Chronic Illness Therapy (FACIT) -Fatigue Subscale Score From Week 12 Through Week 24

    The FACIT-Fatigue subscale includes a 13-item self-reported fatigue subscale, which assesses the severity and impact of fatigue (including the impact on daily activities and functioning).The FACIT-Fatigue subscale is scored on a 5-point Likert scale: 0 (not at all) to 4 (very much). The total FACIT-Fatigue subscale score ranges from 0 to 52, with a higher score indicating better health-related quality of life (HRQOL). Baseline is defined as the last assessment before randomization for subjects randomized and not dosed or the last assessment before start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 12 through Week 24

  2. Double-Blind Period: Change From Baseline in Average Hb Concentration From Week 12 Through Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 12 through Week 24

  3. Double-Blind Period: Percentage of Participants Who Achieved Hb 1.5+ Response From Week 12 Through Week 24 Compared With Baseline

    Hb 1.5+ response is defined as a ≥1.5 g/dL increase in average Hb concentration from Week 12 through Week 24 compared with baseline. Hb 1.5+ response will be summarized using the Mantel-Haenszel stratum weighted method adjusting for randomization stratification factors. Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline up to Week 12 through Week 24

  4. Double-Blind Period: Change From Baseline in Indirect Bilirubin at Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 24

  5. Double-Blind Period: Change From Baseline in Lactate Dehydrogenase (LDH) at Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 24

  6. Double-Blind Period: Change From Baseline in Haptoglobin at Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 24

  7. Double-Blind Period: Change From Baseline in Reticulocytes at Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 24

  8. Double-Blind Period: Change From Baseline in Erythropoietin at Week 24

    Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

    Time frame: Double-Blind Period: Baseline, Week 24

  9. Double-Blind Period: Percentage of Participants Who Achieved Patient Global Impression of Severity (PGIS)- Fatigue Response at Weeks 12, 16, 20, and 24

    PGIS-Fatigue measured participants' perception of their fatigue severity (7-day recall) on a 4-point scale ranging from '1=none' to '4=severe'. A participant was considered to have achieved the PGIS-Fatigue response at Weeks 12, 16, 20, or 24, if their baseline to postbaseline score met one of the following conditions: 'none' at baseline to 'none' postbaseline; 'mild' to 'mild' or 'none'; 'moderate' to 'mild' or 'none'; or 'severe' to 'moderate', 'mild', or 'none'.

    Time frame: Double-Blind Period: At Weeks 12, 16, 20, and 24

  10. Double-Blind Period: Percentage of Participants Who Achieved the Patient Global Impression of Change (PGIC)- Fatigue Response at Weeks 12, 16, 20, and 24

    The PGIC-Fatigue assesses change over time compared with baseline on a 5-point scale ranging from 0 to 4 where 0 indicates Much better and 4 as Much worse. A participant was considered to have achieved the PGIC-Fatigue response at Weeks 12, 16, 20, or 24 if their baseline PGIS and corresponding PGIC met one of the following conditions: if the PGIS at baseline was 'none' or 'mild' and PGIC at the visit was 'no change', 'a little better', or 'much better'; or if the PGIS at baseline was 'moderate' or 'severe' and PGIC at the visit was 'a little better' or 'much better'.

    Time frame: Double-Blind Period: At Weeks 12, 16, 20, and 24

  11. Double-Blind Period: Change From Baseline in the 6-minute Walk Test (6MWT) Distance at Week 24

    The 6MWT is a well-established performance outcome (PerfO) measure that is widely used to evaluate physical activity in terms of distance walked in patients with a variety of conditions. The test measures the distance an individual can walk on a hard, flat surface in 6 minutes.

    Time frame: Double-Blind Period: Baseline, Week 24

  12. Double-Blind Period: Change From Baseline in Serum Ferritin at Week 24

    Iron metabolism was assessed based on serum ferritin levels.

    Time frame: Double-Blind Period: Baseline, Week 24

  13. Double-Blind Period: Change From Baseline in Transferrin Saturation (TSAT) at Week 24

    Iron metabolism was assessed based on TSAT levels. Transferrin saturation is reported by dividing value of serum iron by total iron binding capacity.

    Time frame: Double-Blind Period: Baseline, Week 24

  14. Double-Blind Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs and TEAEs With Severity Greater Than or Equal to Grade 3

    AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with the study drug. A serious adverse event (SAE) is any untoward medical occurrence that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. TEAEs are AEs with an initial onset date during the on-treatment period or worsening from baseline and includes both serious \& non-serious TEAEs. Severity of AEs was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; Version 4.03): grade 1: mild; grade 2: moderate; grade 3: severe or medically significant but not immediately life-threatening; grade 4: life threatening or disabling; grade 5: death related to AE.

    Time frame: Double-Blind Period: From the time of signing informed consent to Week 24

  15. Double-Blind Period: Plasma Concentration of Mitapivat

    Time frame: Double-Blind Period: Pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  16. Double-Blind Period: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUC0-last) of Mitapivat

    Area under the concentration-time curve from time zero to Tlast on dosing day, calculated using the linear-log trapezoidal rule.

    Time frame: Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  17. Double-Blind Period: Time of Last Quantifiable Concentration (Tlast) of Mitapivat

    Time frame: Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  18. Double-Blind Period: Maximum Observed Plasma Concentration (Cmax) of Mitapivat

    Time frame: Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  19. Double-Blind Period: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Mitapivat

    Time frame: Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  20. Double-Blind Period: Last Quantifiable Plasma Concentration (Clast) of Mitapivat

    Time frame: Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  21. Double-Blind Period: Blood Concentration of Adenosine Triphosphate (ATP)

    Time frame: Double-Blind Period: Pre-dose at Day 1; pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  22. Double-Blind Period: Blood Concentration of 2,3 - Diphosphoglycerate (2,3-DPG)

    Time frame: Double-Blind Period: Pre-dose at Day 1; pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20

  23. Open-Label Extension Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs and TEAEs With Severity of Greater Than or Equal to Grade 3

    AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with the study drug. A serious adverse event (SAE) is any untoward medical occurrence that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. TEAEs are AEs with an initial onset date during the on-treatment period or worsening from baseline and includes both serious \& non-serious TEAEs. Severity of abnormalities was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; Version 4.03): grade 1: mild; grade 2: moderate; grade 3: severe or medically significant but not immediately life-threatening; grade 4: life threatening or disabling; grade 5: death related to AE.

    Time frame: Open-Label Extension Period: From week 24 up to end of study (approximately 5 years)

07

Results

Posted Jan 24, 2025

Participant flow

Participants took part in study at study sites in the United States of America, Brazil, Bulgaria, Canada, Denmark, France, Greece, Italy, Lebanon, Malaysia, Netherlands, Saudi Arabia, Spain, Taiwan, Thailand, Turkey, United Arab Emirates and the United Kingdom. Results are reported for 24-week DB period until primary completion date. Analysis of data for OLE period is still ongoing with anticipated completion in December 2028. Results for OLE period will be reported by December 2029.

Participant flow — Overall Study
MilestoneMitapivatPlacebo
Started13064
Treated12963
Completed12262
Not completed82
Withdrew: Randomized, never treated11
Withdrew: Withdrawal by subject31
Withdrew: Adverse event20
Withdrew: Pregnancy10
Withdrew: Other un-specified10

Outcome measures

PrimaryDouble-Blind Period: Percentage of Participants Who Achieved Hemoglobin (Hb) Response From Week 12 Through Week 24 Compared With Baseline

Hb response is defined as ≥10 grams/ liter (g/L) (1.0 gram per deciliter) (g/dL) increase in average Hb concentration from Week 12 through Week 24 compared with baseline. Hb response was tested using the Mantel-Haenszel stratum weighted method adjusting for randomization stratification factors. Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline up to Week 12 through Week 24
Reported as:
Number · Percentage of participants
Double-Blind Period: Percentage of Participants Who Achieved Hemoglobin (Hb) Response From Week 12 Through Week 24 Compared With Baseline
Percentage of participantsMitapivatPlacebo
Double-Blind Period: Percentage of Participants Who Achieved Hemoglobin (Hb) Response From Week 12 Through Week 24 Compared With Baseline42.31.6
Statistical analysis
  • Mitapivat vs Placebo · Cochran-Mantel-Haenszel · p = <0.0001 · Percentage difference: 40.9 · 95% CI 32.0 to 49.8
SecondaryDouble-Blind Period: Change From Baseline in Average Functional Assessment of Chronic Illness Therapy (FACIT) -Fatigue Subscale Score From Week 12 Through Week 24

The FACIT-Fatigue subscale includes a 13-item self-reported fatigue subscale, which assesses the severity and impact of fatigue (including the impact on daily activities and functioning).The FACIT-Fatigue subscale is scored on a 5-point Likert scale: 0 (not at all) to 4 (very much). The total FACIT-Fatigue subscale score ranges from 0 to 52, with a higher score indicating better health-related quality of life (HRQOL). Baseline is defined as the last assessment before randomization for subjects randomized and not dosed or the last assessment before start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 12 through Week 24
Reported as:
Least squares mean · score on a scale
Double-Blind Period: Change From Baseline in Average Functional Assessment of Chronic Illness Therapy (FACIT) -Fatigue Subscale Score From Week 12 Through Week 24
score on a scaleMitapivatPlacebo
Double-Blind Period: Change From Baseline in Average Functional Assessment of Chronic Illness Therapy (FACIT) -Fatigue Subscale Score From Week 12 Through Week 244.85 ± 0.7321.46 ± 0.955
Statistical analysis
  • Mitapivat vs Placebo · ANCOVA · p = 0.0026 · Difference in lean square (ls) mean: 3.40 · 95% CI 1.21 to 5.59
SecondaryDouble-Blind Period: Change From Baseline in Average Hb Concentration From Week 12 Through Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 12 through Week 24
Reported as:
Least squares mean · Gram per Liter (g/L)
Double-Blind Period: Change From Baseline in Average Hb Concentration From Week 12 Through Week 24
Gram per Liter (g/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Average Hb Concentration From Week 12 Through Week 248.57 ± 0.666-1.06 ± 0.867
Statistical analysis
  • Mitapivat vs Placebo · ANCOVA · p = <0.0001 · Difference in ls mean: 9.63 · 95% CI 7.80 to 11.46
SecondaryDouble-Blind Period: Percentage of Participants Who Achieved Hb 1.5+ Response From Week 12 Through Week 24 Compared With Baseline

Hb 1.5+ response is defined as a ≥1.5 g/dL increase in average Hb concentration from Week 12 through Week 24 compared with baseline. Hb 1.5+ response will be summarized using the Mantel-Haenszel stratum weighted method adjusting for randomization stratification factors. Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline up to Week 12 through Week 24
Reported as:
Number · Percentage of participants
Double-Blind Period: Percentage of Participants Who Achieved Hb 1.5+ Response From Week 12 Through Week 24 Compared With Baseline
Percentage of participantsMitapivatPlacebo
Double-Blind Period: Percentage of Participants Who Achieved Hb 1.5+ Response From Week 12 Through Week 24 Compared With Baseline24.60
SecondaryDouble-Blind Period: Change From Baseline in Indirect Bilirubin at Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Micromole per Liter (umol/L)
Double-Blind Period: Change From Baseline in Indirect Bilirubin at Week 24
Micromole per Liter (umol/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Indirect Bilirubin at Week 24-10.65 ± 1.047-0.03 ± 1.403
SecondaryDouble-Blind Period: Change From Baseline in Lactate Dehydrogenase (LDH) at Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Units per Liter (U/L)
Double-Blind Period: Change From Baseline in Lactate Dehydrogenase (LDH) at Week 24
Units per Liter (U/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Lactate Dehydrogenase (LDH) at Week 24-30.07 ± 7.131-5.79 ± 9.440
SecondaryDouble-Blind Period: Change From Baseline in Haptoglobin at Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Gram per Liter (g/L)
Double-Blind Period: Change From Baseline in Haptoglobin at Week 24
Gram per Liter (g/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Haptoglobin at Week 24-0.002 ± 0.01450.017 ± 0.0199
SecondaryDouble-Blind Period: Change From Baseline in Reticulocytes at Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · 10^9 cells per liter (10^9 cells/L)
Double-Blind Period: Change From Baseline in Reticulocytes at Week 24
10^9 cells per liter (10^9 cells/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Reticulocytes at Week 24-32.11 ± 10.600-14.74 ± 14.932
SecondaryDouble-Blind Period: Change From Baseline in Erythropoietin at Week 24

Baseline is defined as the average of all assessments within 42 days before randomization for subjects randomized and not dosed or within 42 days before the start of study treatment for subjects randomized and dosed.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · International units per Liter (IU/L)
Double-Blind Period: Change From Baseline in Erythropoietin at Week 24
International units per Liter (IU/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Erythropoietin at Week 2419.21 ± 37.773115.71 ± 49.413
SecondaryDouble-Blind Period: Percentage of Participants Who Achieved Patient Global Impression of Severity (PGIS)- Fatigue Response at Weeks 12, 16, 20, and 24

PGIS-Fatigue measured participants' perception of their fatigue severity (7-day recall) on a 4-point scale ranging from '1=none' to '4=severe'. A participant was considered to have achieved the PGIS-Fatigue response at Weeks 12, 16, 20, or 24, if their baseline to postbaseline score met one of the following conditions: 'none' at baseline to 'none' postbaseline; 'mild' to 'mild' or 'none'; 'moderate' to 'mild' or 'none'; or 'severe' to 'moderate', 'mild', or 'none'.

Time frame:
Double-Blind Period: At Weeks 12, 16, 20, and 24
Reported as:
Number · percentage of participants
Double-Blind Period: Percentage of Participants Who Achieved Patient Global Impression of Severity (PGIS)- Fatigue Response at Weeks 12, 16, 20, and 24
percentage of participantsMitapivatPlacebo
At Week 1265.446.9
At Week 1663.142.2
At Week 2061.548.4
At Week 2462.346.9
SecondaryDouble-Blind Period: Percentage of Participants Who Achieved the Patient Global Impression of Change (PGIC)- Fatigue Response at Weeks 12, 16, 20, and 24

The PGIC-Fatigue assesses change over time compared with baseline on a 5-point scale ranging from 0 to 4 where 0 indicates Much better and 4 as Much worse. A participant was considered to have achieved the PGIC-Fatigue response at Weeks 12, 16, 20, or 24 if their baseline PGIS and corresponding PGIC met one of the following conditions: if the PGIS at baseline was 'none' or 'mild' and PGIC at the visit was 'no change', 'a little better', or 'much better'; or if the PGIS at baseline was 'moderate' or 'severe' and PGIC at the visit was 'a little better' or 'much better'.

Time frame:
Double-Blind Period: At Weeks 12, 16, 20, and 24
Reported as:
Number · percentage of participants
Double-Blind Period: Percentage of Participants Who Achieved the Patient Global Impression of Change (PGIC)- Fatigue Response at Weeks 12, 16, 20, and 24
percentage of participantsMitapivatPlacebo
At Week 1271.553.1
At Week 1671.550.0
At Week 2066.256.3
At Week 2466.253.1
SecondaryDouble-Blind Period: Change From Baseline in the 6-minute Walk Test (6MWT) Distance at Week 24

The 6MWT is a well-established performance outcome (PerfO) measure that is widely used to evaluate physical activity in terms of distance walked in patients with a variety of conditions. The test measures the distance an individual can walk on a hard, flat surface in 6 minutes.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Meters
Double-Blind Period: Change From Baseline in the 6-minute Walk Test (6MWT) Distance at Week 24
MetersMitapivatPlacebo
Double-Blind Period: Change From Baseline in the 6-minute Walk Test (6MWT) Distance at Week 2430.48 ± 5.6517.11 ± 7.346
SecondaryDouble-Blind Period: Change From Baseline in Serum Ferritin at Week 24

Iron metabolism was assessed based on serum ferritin levels.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Microgram/Liter (mcg/L)
Double-Blind Period: Change From Baseline in Serum Ferritin at Week 24
Microgram/Liter (mcg/L)MitapivatPlacebo
Double-Blind Period: Change From Baseline in Serum Ferritin at Week 24-34.75 ± 32.710-32.48 ± 43.090
SecondaryDouble-Blind Period: Change From Baseline in Transferrin Saturation (TSAT) at Week 24

Iron metabolism was assessed based on TSAT levels. Transferrin saturation is reported by dividing value of serum iron by total iron binding capacity.

Time frame:
Double-Blind Period: Baseline, Week 24
Reported as:
Least squares mean · Ratio
Double-Blind Period: Change From Baseline in Transferrin Saturation (TSAT) at Week 24
RatioMitapivatPlacebo
Double-Blind Period: Change From Baseline in Transferrin Saturation (TSAT) at Week 24-0.029 ± 0.0212-0.047 ± 0.0262
SecondaryDouble-Blind Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs and TEAEs With Severity Greater Than or Equal to Grade 3

AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with the study drug. A serious adverse event (SAE) is any untoward medical occurrence that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. TEAEs are AEs with an initial onset date during the on-treatment period or worsening from baseline and includes both serious \& non-serious TEAEs. Severity of AEs was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; Version 4.03): grade 1: mild; grade 2: moderate; grade 3: severe or medically significant but not immediately life-threatening; grade 4: life threatening or disabling; grade 5: death related to AE.

Time frame:
Double-Blind Period: From the time of signing informed consent to Week 24
Reported as:
Count of participants · Participants
Double-Blind Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs and TEAEs With Severity Greater Than or Equal to Grade 3
ParticipantsMitapivatPlacebo
Participants with TEAEs10750
Participants with Serious TEAEs80
Participants with TEAEs related to study drug5613
Participants with any TEAE of Grade ≥ 3182
SecondaryDouble-Blind Period: Plasma Concentration of Mitapivat
Time frame:
Double-Blind Period: Pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Mean · nanograms per milliliter (ng/mL)
Double-Blind Period: Plasma Concentration of Mitapivat
nanograms per milliliter (ng/mL)Mitapivat
Pre-dose at Week 1259.23 ± 51.081
Pre-dose at Week 2084.70 ± 138.852
30 Minutes Post-dose at Week 201209.00 ± 931.211
1 Hour Post-dose at Week 201386.35 ± 712.996
3 Hour Post-dose at Week 20740.26 ± 357.660
5 Hour Post-dose at Week 20359.42 ± 269.758
7 Hour Post-dose at Week 20206.82 ± 185.657
SecondaryDouble-Blind Period: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUC0-last) of Mitapivat

Area under the concentration-time curve from time zero to Tlast on dosing day, calculated using the linear-log trapezoidal rule.

Time frame:
Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Geometric mean · Hours*nanogram per milliliter (h*ng/mL)
Double-Blind Period: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUC0-last) of Mitapivat
Hours*nanogram per milliliter (h*ng/mL)Mitapivat
Double-Blind Period: Area Under the Plasma Concentration-time Curve From Time Zero to the Last Measurable Concentration (AUC0-last) of Mitapivat4262.57 ± 31.4
SecondaryDouble-Blind Period: Time of Last Quantifiable Concentration (Tlast) of Mitapivat
Time frame:
Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Median · hours
Double-Blind Period: Time of Last Quantifiable Concentration (Tlast) of Mitapivat
hoursMitapivat
Double-Blind Period: Time of Last Quantifiable Concentration (Tlast) of Mitapivat6.825 (6.50 to 7.42)
SecondaryDouble-Blind Period: Maximum Observed Plasma Concentration (Cmax) of Mitapivat
Time frame:
Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Geometric mean · ng/mL
Double-Blind Period: Maximum Observed Plasma Concentration (Cmax) of Mitapivat
ng/mLMitapivat
Double-Blind Period: Maximum Observed Plasma Concentration (Cmax) of Mitapivat1565.69 ± 42.4
SecondaryDouble-Blind Period: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Mitapivat
Time frame:
Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Median · Hours
Double-Blind Period: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Mitapivat
HoursMitapivat
Double-Blind Period: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Mitapivat1.000 (0.20 to 5.00)
SecondaryDouble-Blind Period: Last Quantifiable Plasma Concentration (Clast) of Mitapivat
Time frame:
Double-Blind Period: Pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Geometric mean · ng/mL
Double-Blind Period: Last Quantifiable Plasma Concentration (Clast) of Mitapivat
ng/mLMitapivat
Double-Blind Period: Last Quantifiable Plasma Concentration (Clast) of Mitapivat166.93 ± 80.1
SecondaryDouble-Blind Period: Blood Concentration of Adenosine Triphosphate (ATP)
Time frame:
Double-Blind Period: Pre-dose at Day 1; pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Mean · microgram/milliliter (mcg/mL)
Double-Blind Period: Blood Concentration of Adenosine Triphosphate (ATP)
microgram/milliliter (mcg/mL)MitapivatPlacebo
At Pre-dose at Day 1180.87 ± 29.577184.91 ± 31.299
Pre-dose at Week 12242.07 ± 45.782176.81 ± 33.657
Pre-dose at Week 20235.79 ± 46.099168.10 ± 29.962
30 Minutes Post-dose at Week 20417.87 ± 102.853457.78 ± 89.932
1 Hour Post-dose at Week 20417.83 ± 105.752457.71 ± 104.431
3 Hour Post-dose at Week 20409.73 ± 96.379454.39 ± 107.966
5 Hour Post-dose at Week 20412.72 ± 94.150464.24 ± 97.007
7 Hour Post-dose at Week 20404.43 ± 97.586471.10 ± 113.165
SecondaryDouble-Blind Period: Blood Concentration of 2,3 - Diphosphoglycerate (2,3-DPG)
Time frame:
Double-Blind Period: Pre-dose at Day 1; pre-dose at Week 12; pre-dose, 0.5, 1, 3, 5, 7 hours post-dose at Week 20
Reported as:
Mean · mcg/mL
Double-Blind Period: Blood Concentration of 2,3 - Diphosphoglycerate (2,3-DPG)
mcg/mLMitapivatPlacebo
Pre-dose at Day 1526.40 ± 125.196506.14 ± 108.033
Pre-dose at Week 12434.90 ± 97.901497.68 ± 112.055
Pre-dose at Week 20426.30 ± 107.173468.22 ± 99.783
30 Minutes Post-dose at Week 20417.87 ± 102.853457.78 ± 89.932
1 Hour Post-dose at Week 20417.83 ± 105.752457.71 ± 104.431
3 Hour Post-dose at Week 20409.73 ± 96.379454.39 ± 107.966
5 Hour Post-dose at Week 20412.72 ± 94.150464.24 ± 97.007
7 Hour Post-dose at Week 20404.43 ± 97.586471.10 ± 113.165
SecondaryOpen-Label Extension Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs and TEAEs With Severity of Greater Than or Equal to Grade 3

AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with the study drug. A serious adverse event (SAE) is any untoward medical occurrence that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. TEAEs are AEs with an initial onset date during the on-treatment period or worsening from baseline and includes both serious \& non-serious TEAEs. Severity of abnormalities was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; Version 4.03): grade 1: mild; grade 2: moderate; grade 3: severe or medically significant but not immediately life-threatening; grade 4: life threatening or disabling; grade 5: death related to AE.

Time frame:
Open-Label Extension Period: From week 24 up to end of study (approximately 5 years)

Results for this outcome have not been posted.

Adverse events

Collected over Double-blind period: From the time of signing informed consent to Week 24. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Mitapivat0/130 (0%)8/129 (6.2%)80/129 (62%)
Placebo0/64 (0%)0/63 (0%)33/63 (52.4%)
Most frequent serious events
Most frequent serious events
EventMitapivatPlacebo
Lower respiratory tract infectionInfections and infestations1/1290/63
PneumoniaInfections and infestations1/1290/63
Upper respiratory tract infectionInfections and infestations1/1290/63
Craniofacial fractureInjury, poisoning and procedural complications1/1290/63
Ulna fractureInjury, poisoning and procedural complications1/1290/63
AnaemiaBlood and lymphatic system disorders1/1290/63
Angina pectorisCardiac disorders1/1290/63
Abdominal painGastrointestinal disorders1/1290/63
Superficial vein thrombosisVascular disorders1/1290/63
Most frequent other events
Showing 10 of 15
Most frequent other events
EventMitapivatPlacebo
HeadacheNervous system disorders29/1296/63
Initial insomniaPsychiatric disorders18/1293/63
NauseaGastrointestinal disorders15/1295/63
Upper respiratory tract infectionInfections and infestations13/1294/63
InfluenzaInfections and infestations5/1296/63
DiarrhoeaGastrointestinal disorders11/1296/63
PyrexiaGeneral disorders4/1296/63
FatigueGeneral disorders12/1294/63
COVID-19Infections and infestations8/1295/63
Back painMusculoskeletal and connective tissue disorders3/1295/63

Baseline characteristics

Full Analysis Set (FAS) included all participants who were randomized.

Age, Continuous
Age, Continuous(years)MitapivatPlaceboTotal
Mean42.4 ± 13.0338.9 ± 12.9941.2 ± 13.09
Sex: Female, Male
Sex: Female, Male(Participants)MitapivatPlaceboTotal
Female8439123
Male462571
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)MitapivatPlaceboTotal
Hispanic or Latino11617
Not Hispanic or Latino11858176
Unknown or Not Reported101
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)MitapivatPlaceboTotal
White7336109
Asian522476
Black or African American112
American Indian or Alaska Native000
Native Hawaiian or Other Pacific Islander000
Multiracial101
Unknown224
Not reported112
08

Study locations

68 sites
  • San Diego Hospital, UC San Diego Health
    La Jolla, California 92093, United States
  • Stanford Medicine
    Palo Alto, California 94304-1601, United States
  • Massachusetts General Hospital
    Boston, Massachusetts 02114-2696, United States
  • Weill Cornell Medical Center
    New York, New York 10065-4870, United States
  • Duke University Medical Center
    Durham, North Carolina 27710-3038, United States
  • Penn Medicine - University of Pennsylvania Health System
    Philadelphia, Pennsylvania 19104, United States
  • Universidade de Caxias do Sul
    Caxias do Sul, 95070-560, Brazil
  • Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP
    Ribeirão Preto, 14051-260, Brazil
  • HEMORIO Instituto Nacional de Hematologia
    Rio de Janeiro, 20211-030, Brazil
  • Praxis Pesquisa Medica
    Santo André, 09090-790, Brazil
  • GSH Banco de Sangue de São Paulo
    São Paulo, 04006-002, Brazil
  • Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidad de São Paulo
    São Paulo, 05403-000, Brazil
  • MHAT "Dr. Nikola Vasiliev" AD
    Kyustendil, 2500, Bulgaria
  • SHATHD Sofia
    Sofia, 1756, Bulgaria
  • Toronto General Hospital, University Health Network
    Toronto, M5G 2C4, Canada
  • Rigshospitalet
    Copenhagen, 2100, Denmark
  • CHU Hôpital Henri Mondor
    Créteil, 94010, France
  • Hopital Edouard Herriot, CHU de Lyon
    Lyon, 69003, France
  • Laiko General Hospital
    Athens, 115 26, Greece
  • Children's Hospital Agia Sophia, National and Kapodistrian University of Athens Medical School
    Athens, 115 27, Greece
  • University General Hospital of Patras
    Rio, 26504, Greece
  • Ippokrateio General Hospital
    Thessaloniki, 546 42, Greece
  • Ospedale "A. Perrino" - Brindisi
    Brindisi, 72100, Italy
  • Ospedale Pediatrico Microcitemico
    Cagliari, 09121, Italy
  • Ospedale Sant'Anna
    Ferrara, 44124, Italy
  • Ente Ospedaliero Ospedali Galliera
    Genova, 16128, Italy
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
    Milan, 20122, Italy
  • A.O.U Di Modena
    Modena, 41124, Italy
  • A.O.R.N. "A. Cardarelli"
    Naples, 80131, Italy
  • AOU L. Vanvitelli Universita degli Studi della Campania Luigi Vanvitelli
    Naples, 80138, Italy
  • A.O.U. San Luigi Gonzaga
    Orbassano, 10043, Italy
  • Chronic Care Center
    Beirut, 9999, Lebanon
  • Hospital Sultanah Bahiyah
    Alor Star, 05460, Malaysia
  • Hospital Ampang
    Ampang, 68000, Malaysia
  • Hospital Sultanah Aminah Johor Bahru
    Johor Bahru, 80100, Malaysia
  • Hospital Queen Elizabeth, Kota Kinabalu
    Kota Kinabalu, 88586, Malaysia
  • Hospital Tunku Azizah
    Kuala Lumpur, 50300, Malaysia
  • Hospital Tengku Ampuan Afzan
    Kuantan, 25100, Malaysia
  • Hospital Umum Sarawak
    Kuching, 93586, Malaysia
  • Hospital Pulau Pinang
    Pulau Pinang, 10990, Malaysia
  • Erasmus MC
    Rotterdam, 3015 GD, Netherlands
  • Universitair Medisch Centrum Utrecht
    Utrecht, 3584 CX, Netherlands
  • King Abdulaziz Hospital - Al Ahsa
    Al Mubarraz, 36428, Saudi Arabia
  • King Abdullah International Medical Research Center
    Riyadh, 14611, Saudi Arabia
  • Hospital Universitario Vall d'Hebron
    Barcelona, 08035, Spain
  • Hospital Universitario La Paz
    Madrid, 28046, Spain
  • Hospital Universitario Virgen Arrixaca
    Murcia, 30120, Spain
  • Hospital Universitario Virgen del Rocío
    Seville, 41013, Spain
  • China Medical University, Taiwan
    Taichung, 40447, Taiwan
  • Phramongkutklao Hospital
    Bangkok, 10400, Thailand
  • Ramathibodi Hospital
    Bangkok, 10400, Thailand
  • Faculty of Medicine Siriraj Hospital
    Bangkok, 10700, Thailand
  • Maharaj Nakorn Chiang Mai Hospital
    Chiang Mai, 50200, Thailand
  • Srinagarind Hospital, Khon Kaen University
    Khon Kaen, 40002, Thailand
  • Naresuan University Hospital
    Mueang Phitsanulok, 65000, Thailand
  • King Chulalongkorn Memorial Hospital
    Pathum Wan, 10330, Thailand
  • Acibadem Adana Hospital
    Adana, 01130, Turkey (Türkiye)
  • Akdeniz University Faculty of Medicine
    Antalya, 07059, Turkey (Türkiye)
  • Çukurova University
    Balcalı, 01330, Turkey (Türkiye)
  • Ege University Faculty of Medicine
    Bornova, 35040, Turkey (Türkiye)
  • Istanbul University Faculty of Medicine
    Fatih, 34093, Turkey (Türkiye)
  • Hacettepe University
    Mersin, 06230, Turkey (Türkiye)
  • Burjeel Medical City
    Abu Dhabi, United Arab Emirates
  • Thalassemia Centre Dubai
    Dubai, 4545, United Arab Emirates
  • Cambridge University Hospitals NHS Foundation Trust - Addenbrookes Hospital
    Cambridge, CAM CB2 0QQ, United Kingdom
  • Manchester Royal Infirmary, Manchester University NHS Foundation Trust
    Manchester, LAN M13 9WL, United Kingdom
  • University College London
    London, NW1 2PG, United Kingdom
  • Imperial College Healthcare NHS Trust - Hammersmith Hospital
    London, W12 OHS, United Kingdom
09

References and documents

Publications

  • Taher AT, Al-Samkari H, Aydinok Y, Besser M, Boscoe AN, Dahlin JL, De Luna G, Estepp JH, Gheuens S, Gilroy KS, Glenthoj A, Sim Goh A, Iyer V, Kattamis A, Loggetto SR, Morris S, Musallam KM, Osman K, Ricchi P, Salido-Fierrez E, Sheth S, Tai F, Tevich H, Uhlig K, Urbstonaitis R, Viprakasit V, Cappellini MD, Kuo KHM; ENERGIZE investigators. Mitapivat in adults with non-transfusion-dependent alpha-thalassaemia or beta-thalassaemia (ENERGIZE): a phase 3, international, randomised, double-blind, placebo-controlled trial. Lancet. 2025 Jul 5;406(10498):33-42. doi: 10.1016/S0140-6736(25)00635-X. Epub 2025 Jun 19. PubMed 40544857 ↗

Study documents

  • Study protocol · Aug 5, 2024
  • Statistical analysis plan · Nov 14, 2022

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

1 registry update since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date
1 update, last Sep 28, 2026
Show all 1 update
  1. Sep 28, 2026
    Minor edits only
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

11

Registry details

Key details

Study ID
NCT04770753
Lead sponsor
Agios Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Feb 25, 2021
Start date
Dec 20, 2021
Primary completion
Nov 13, 2023
Completion
Dec 2028 (estimated)
Results posted
Jan 24, 2025
Last update
Sep 28, 2026

Study contacts

Medical Affairs
study chair · Agios Pharmaceuticals, Inc.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is active, not recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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